Perceived Reduced Sleep-Related Erections in Subjects with Erectile Dysfunction: Psychobiological Correlates

Abstract

Introduction Perceived reduced sleep-related erections (PR-SREs), along with erectile dysfunction (ED) and hypoactive sexual desire, have been recently recognized as the most important symptoms characterizing late-onset hypogonadism in community-dwelling European men. However, the clinical correlates of PR-SREs have not been thoroughly investigated. Aim To evaluate the psychobiological correlates of PR-SREs in a large series of subjects consulting for ED. Methods A consecutive series of 3,888 (mean age 51.6 ± 13.0 years) ED patients attending an outpatient ED clinic was retrospectively analyzed. Main Outcome Measures PR-SREs were investigated using validated question #13 of structured interview on ED, which showed an accuracy of approximately 70% in predicting Rigiscan™ (Dacomed Corp., Minneapolis, MN, USA) parameters in a consecutive subset of 199 subjects. Clinical, biochemical, hormonal, instrumental (penile color Doppler ultrasound; PCDU), and intrapsychic (Middlesex Health Questionnaire) correlates were also evaluated. Results PR-SREs were reported by 63.6% of patients. After adjustment for age, total, analog free, calculated free and calculated bioavailable testosterone (T) were significantly lower in subjects reporting more severe PR-SREs. After adjusting for T levels and other confounders, PR-SREs were still associated with higher body mass index, glucose, and triglyceride levels, as well as with an increased 10-year cardiovascular risk score. Accordingly, PR-SREs were more prevalent in subjects showing a reduced dynamic peak systolic velocity at PCDU or reporting severe ED. Among intrapsychic parameters, depressive and histrionic traits were significantly higher and lower, respectively, in subjects with any degree of PR-SREs. Conclusions Our study indicates that investigating PR-SREs represents an important step during the andrological consultation. In fact, reduced SREs might indicate an endocrine, organic, and/or psychiatric ED background that might help in directing further investigation.

Sex Hormone Levels, Genetic Androgen Receptor Polymorphism, and Anxiety in ≥50-Year-Old Males

“…As published before, lower testosterone levels were found in subjects with ED [40,52,53]. Our results show an interesting association of ED with higher anxiety levels.…”

Impact of aging and comorbidity on the efficacy of low‐intensity shock wave therapy for erectile dysfunction

“…In the current study, MPCC (reflecting SRE) was significantly improved, and it was also affected by age and concurrent comorbidities. Testosterone level largely influences SRE; however, there was no significant change in free testosterone level after LI‐SWT (data not shown). Indeed, MPCC using the erectometer added the reliable consequence of LI‐SWT efficacy to this study.…”

Erectile dysfunction and central obesity: an Italian perspective

“…The associations retained significance in an ordinal logistic model, even after adjusting for TT, smoking habit and age ( Figure 2 ). In a similar ordinal model, we also explored possible associations between increasing WC and other aspects of male sexuality, such as reduced spontaneous erection, hypoactive sexual desire and premature ejaculation, measured as previously reported 42484950. Both increasing severity of reduced spontaneous erection and loss of libido were positively associated with increased WC (Wald = 30.151, n = 3433, P < 0.0001 and Wald = 8.622, n = 3456, P < 0.005; respectively), while premature ejaculation showed an opposite trend, being less prevalent in abdominal obese individuals (Wald = 4.457, n = 3416, P < 0.05).…”